Freelance caregivers are individual home caregivers hired directly by a family, without going through an agency. They typically cost 20 to 40 percent less than agency caregivers but require the family to act as an employer. We track 43,195 freelance and individual caregivers listed in the CMS provider registry. Rates typically run $18 to $30 per hour.
Key takeaways
- Freelance caregivers are hired directly by the family, not through an agency. Cheaper per hour but more responsibility.
- Typical rates: $18 to $30 per hour, vs $25 to $45 for agency caregivers. Savings come from cutting out the agency markup.
- The family becomes the employer, responsible for hiring, screening, taxes, workers comp, and finding backup coverage.
- Best for families with time, organization, and a lawyer or accountant to help with employer obligations.
- Use written contracts. Do payroll properly. Check references. Get workers comp. Skipping these creates legal and financial risk.
What is Independent Caregiver?
A freelance or independent caregiver is someone you hire directly to provide in-home care, without going through a home care agency. They may be a certified nursing assistant, a home health aide, or a person experienced in senior care without a formal certification. The family sets the schedule, the pay rate, and the job duties, and the caregiver reports directly to the family. This model saves money — agency rates include a 30 to 50 percent markup for hiring, training, taxes, insurance, and backup coverage. But those services matter, and the family takes them on when they hire independently. You become the employer with all the tax, insurance, and legal obligations that entails. Many families use a payroll service or a household employer service (companies like HomePay, Care.com HomePay, or Poppins Payroll) to handle the tax withholding and W-2 issuance. Skip these steps at your own risk: paying under the table exposes the family to serious back taxes and penalties, and lack of workers comp exposes them to catastrophic liability if the caregiver gets hurt in the home.
How much does independent caregiver cost?
Median: $22/month · based on 43,195 independent caregiver providers we track
Freelance caregivers typically charge $18 to $30 per hour, compared to $25 to $45 through an agency. For 40 hours per week, that saves roughly $600 to $1,200 per month. Live-in caregivers might charge $150 to $250 per day, less than the $200 to $350 typical through an agency.
The savings are real but you need to add in the "hidden costs" the agency was covering. Employer payroll taxes add about 8 percent to gross wages. Workers comp insurance is typically $200 to $600 per year for a household employee. You also need to plan for backup coverage when the caregiver is sick or on vacation, which often means hiring a second caregiver on standby.
A payroll service like HomePay or Poppins Payroll runs $50 to $80 per month and handles all the tax paperwork. That is money well spent to avoid IRS trouble.
Who is independent caregiver right for?
Independent Caregiver is usually the right fit when your loved one is:
- Family has time and organization to manage a household employee
- Looking to save 20 to 40 percent vs agency rates
- Wants a specific caregiver, often through personal reference or word of mouth
- Comfortable handling payroll, taxes, and insurance obligations (with a service)
- Not in an emergency situation (agencies are faster to stand up)
- Has a backup plan for when the primary caregiver is unavailable
Services typically included
- Help with bathing, dressing, and grooming
- Medication reminders
- Meal preparation
- Light housekeeping and laundry
- Transportation and errands
- Companionship and mental engagement
- Overnight or 24-hour coverage if arranged
- Some caregivers: dementia experience, hospice comfort care
- Note: independent caregivers cannot legally provide skilled medical care unless they hold the appropriate license
How to pay for independent caregiver
Medicare
Medicare does not pay for freelance caregivers. Medicare only pays for care from licensed home health agencies (short-term, after a hospitalization). Independent caregivers are outside that system.
Medicaid
Some state Medicaid HCBS waivers allow "consumer-directed" care, where the family hires and directs a caregiver (sometimes even a family member) using Medicaid funds. Rules vary by state. Contact your state Medicaid office or Area Agency on Aging.
VA Aid & Attendance
The Aid & Attendance benefit can be used to pay a freelance caregiver directly. Some veterans choose this route to hire a specific person or a family member.
Long-term care insurance
Some LTC policies cover care from independent caregivers; others require an agency. Check your policy language. If they cover it, keep meticulous records: hours worked, tasks performed, and payments made.
Private pay
Most freelance caregivers are paid privately by the family. Use a payroll service. Do it right. The IRS treats household employees seriously.
How to choose an independent caregiver provider
- Do a thorough background check. Services like Checkr or Sterling cost $30-50 and check criminal history, driving record, and identity.
- Verify credentials if applicable. CNAs and HHAs are listed in state registries — confirm the caregiver is on it.
- Call every reference. Ask specific questions: Was the caregiver on time? How did they handle difficult behaviors? Would you rehire?
- Use a written contract. Cover rate, hours, duties, notice for termination, and confidentiality.
- Get workers compensation insurance. Cheap, mandatory in most states, and essential if the caregiver gets hurt in the home.
- Set up payroll properly through a service like HomePay or Poppins. Do not pay under the table.
Independent Caregiver vs other care types
Independent Caregiver vs Home Care Agencies
Explore Home Care AgenciesAgencies cost more per hour but handle everything: hiring, background checks, training, taxes, and backup when a caregiver is out. Freelance caregivers save money but shift all that work to you. Trade cost for time.
Independent Caregiver vs Adult Day Care
Explore Adult Day CareAdult day care handles daytime supervision. A freelance caregiver at home can handle mornings, evenings, weekends, or specific hours. Many families combine adult day care during the week with a freelance caregiver on weekends.
Independent Caregiver vs Assisted Living
Explore Assisted LivingA freelance caregiver at home is usually cheaper than assisted living below 30 hours per week and more expensive above 40. If your loved one needs round-the-clock coverage, assisted living usually wins on cost and reliability.
Frequently asked questions
What is a freelance caregiver?
An individual caregiver hired directly by a family, without going through a home care agency. The family becomes the household employer and handles hiring, taxes, and backup coverage in exchange for lower hourly rates.
How much does a freelance caregiver cost?
Typically $18 to $30 per hour, vs $25 to $45 through an agency. Add about 8 percent for payroll taxes and $200 to $600 per year for workers comp insurance.
Do I need to pay payroll taxes for a freelance caregiver?
Yes, in almost all cases the caregiver is a household employee and you owe employer taxes (Social Security, Medicare, unemployment). Paying "under the table" is illegal and creates serious back-tax risk. Use a payroll service.
Do I need workers comp insurance?
Yes, in most states. Workers comp is inexpensive ($200 to $600 per year for a household employee) and protects both the family and the caregiver if an on-the-job injury happens.
How do I find a freelance caregiver?
Personal referrals are the best source. Also: nursing schools, senior centers, church bulletin boards, Care.com, and this directory. Always do a background check and check references before hiring.
What happens if my freelance caregiver is sick?
You are responsible for backup. Some families keep a second caregiver on standby; others have a home care agency they call for emergency coverage. Not having a backup plan is one of the biggest risks of hiring independently.
Can a family member be paid as a caregiver?
Yes, in some cases. Some state Medicaid waivers pay family members. VA Aid & Attendance can also be used to pay a family caregiver. Consult an elder-law attorney for the tax and eligibility implications.